In general, surgical retractors are used to push, pull, hold and/or fold skin, flesh and/or other tissue away from a site where a surgical operation or other intervention is being performed. Retractors expand the cavity or working area around the site, providing more room in which to maneuver operating and diagnostic tools. Retractors have also been used to facilitate separation of various tissues from architectures proximal to the surgical site, thereby improving access to and visibility of the site.
Historically, surgical retractors have been comprised of two main parts: a body or handle portion and an insertion portion or insert. The body is typically held by an operator when manipulating the retractor or coupled to a support frame that may include weights or mechanisms designed to facilitate desired movements and hold the retractor in place. The insert is suitably configured to move or grasp the desired tissues. For example, by putting a hook-shaped insert into a surgical cavity and then rotating it, surrounding tissues may be snared and then pulled away from the working environment. Not surprisingly, a single size and shape for retractors has not been practical. Indeed, a wide variety of geometries has been developed for different surgical procedures. Retractors have also been used in conjunction with external lighting systems wherein the retractor holds the body tissue out of the way while the lighting system concurrently illuminates the body cavity. However, relying on directed lighting external to a surgical cavity can be problematic due to difficulties in projecting the light in the required direction and shadows that may be cast onto the operating field. Moreover, separate retracting and lighting systems may be frustrating for an operator who is forced to manipulate both systems simultaneously, and various problems may arise as separate lighting and retracting tools get in the way of each other and cross paths with other equipment in the operating room.
Some retractor designs have sought to integrate retracting and lighting functions into a single device. However, the various complex ways of housing light sources and delivering light to the inserts in many of these illuminated or lit retractors have produced limited retractor geometries, bulky and/or heavy handles and inserts, and/or maintenance issues. Furthermore, some illuminated retractors have tended to emit narrow spot beams of light directed to rather small locations of the operating site. As such an illuminated retractor is moved, as is typically necessary to perform its very retracting function, the narrow spot beam of light is concurrently (and undesirably) moved around the cavity in various directions. While some other illuminated retractors have been designed to provide more diffuse lighting, historical diffusion techniques such as frost or ground lenses can produce light losses that reduce the overall intensity or brightness (relative to the light source) of any light that is eventually delivered to the cavity. Moreover, depending on the application, sometimes the availability of a directed beam may be desirable.
Consequently, the competing needs for variety in size and geometry, directed lighting and diffuse lighting, and simplicity have tended to limit the effectiveness of historical illuminated retractors.